Circumcision

Male circumcision is the surgical removal of some or all of the foreskin (prepuce) from the penis. The word "circumcision" comes from Latin circum (meaning "around") and cædere (meaning "to cut"). Early depictions of circumcision are found in cave paintings and Ancient Egyptian tombs, though some pictures are open to interpretation. Religious male circumcision is considered a commandment from God in Judaism. In Islam, though not discussed in the Qur'an, male circumcision is widely practised and most often considered to be a sunnah. It is also customary in some Christian churches in Africa.

Global estimates by the World Health Organization (WHO) suggest that 30 percent of males are circumcised, of whom 68 percent are Muslim. The prevalence of circumcision varies mostly with religious affiliation, and sometimes culture. Most circumcisions are performed during adolescence for cultural or religious reasons; in some countries they are more commonly performed during infancy. Circumcision is also used therapeutically, as one of the treatment options for balanitis xerotica obliterans, paraphimosis, balanitis, posthitis, balanoposthitis and urinary tract infections.

Circumcision reduces the risk of HIV infection in heterosexual populations that are at high risk. Evidence among heterosexual men in sub-Saharan Africa shows a decreased risk of between 38 percent and 66 percent over two years and in this population it appears cost effective. Evidence of benefit for women is controversial and evidence of benefit in developed countries and among men who have sex with men is yet to be determined. The WHO currently recommends circumcision as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV. Ethical concerns remain regarding the implementation of campaigns to promote circumcision. According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision. Some bodies have discussed under what circumstances neonatal circumcision is ethical.

There is controversy regarding circumcision. Arguments that have been raised in opposition to circumcision include that it adversely affects penile function and sexual pleasure, is justified only by medical myths, is extremely painful, and is a violation of human rights. Those raised in favour of circumcision include that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period.